ECONOMIC SURVEY 2020-2021 - VOLUME 1 Summary by NEXT IAS

 
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ECONOMIC SURVEY 2020-2021 - VOLUME 1 Summary by NEXT IAS
ECONOMIC SURVEY
   2020-2021
    VOLUME 1
 Summary by NEXT IAS
ECONOMIC SURVEY 2020-2021 - VOLUME 1 Summary by NEXT IAS
ECONOMIC SURVEY 2020-2021 - VOLUME 1 Summary by NEXT IAS
ECONOMIC SURVEY 2020-2021 - VOLUME 1 Summary by NEXT IAS
Economic Survey 2020-2021                                                                                                  Volume 1
4
               Summary by NEXT IAS

          01                      SAVING LIVES AND LIVELIHOODS AMIDST
    CHAPTER                            A ONCE-IN-A-CENTURY CRISIS
                                                 Saving a life that is in jeopardy is the origin of dharma
                                                  —Mahabharat (Shanti Parva, Chapter 13 Shloka 598)

    About:

                                                                                                          S
                                                                              Economic activity in States with higher initial stringency
    • In this unprecedented global crisis of Covid-19, India focused           has rebounded faster during the year.
      on saving lives and livelihoods by its willingness to take short-   • Impact of Covid on Economy: Also, India recognized that,
      term pain for long-term gain.                                         unlike any previous crises,

                                                                                                        A
    • India recognized that while GDP growth will recover from the           The Covid pandemic affects both demand and supply.
      temporary shock caused by the pandemic, human lives that               It leads to loss of productive capacity due to hysteresis

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      are lost cannot be brought back.                                          caused by financial distress of firms and disruptions in the
                                                                                labor markets that can affect disposable income
    • This strategy tailored to India’s unique vulnerabilities to the
      pandemic                                                            Thus, a slew of structural reforms was announced to help expand
                                                                          supply significantly in the medium to long term.
       As pandemic spreads via human contact, a huge
                                                                          • Steps for economic recovery: Thus, at the onset of the

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         population with high density inherently enables a higher
         pace of spread.                                                    pandemic, India’s policies focused purely on necessities on
       India has one of the largest most vulnerable elderly                the demand side.
         population.                                                         During the unlock phase, demand-side measures have

                    X
       India’s overburdened health infrastructure exposed the                 been announced in a calibrated manner.
         country to a massive supply-demand mismatch that could              A public investment program centered around the
         have severely exacerbated fatalities.                                 National Infrastructure Pipeline is likely to accelerate this
                                                                               demand push and further the recovery.
    • Thus, India imposed the most stringent lockdown at the

                   E
                                                                          • The upturn in the economy while avoiding the second
      beginning itself
                                                                            wave of infections makes India a unique case in strategic
       It enabled flattening of the pandemic curve and
                                                                            policymaking amidst a once in- a-century pandemic.
       It provided the necessary time to ramp up the health and
         testing infrastructure.                                          Covid-19: Once in a Century ‘Crisis’:

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    • Role of Lockdown in saving lives: This chapter via data analysis    • The only strategy that seemed viable for containment of the
      tries to demonstrate that lockdown had a causal impact on             pandemic was active surveillance, early detection, isolation
      saving lives and the economic recovery                                and case management, contact tracing, and prevention of
       India restricted the COVID-19 spread by 37 lakh cases               onward spread by practicing social distancing and safety
          and saved more than 1 lakh lives across the country.              precautions.
    • A stringency index was constructed to compare states                • Various non-pharmaceutical interventions (NPIs) – such as
      to show that the under-or-over performance in cases and               lockdowns, closure of schools and non-essential business,
      deaths (compared to the expected) correlates strongly with            travel restrictions – were adopted to slow down the
      the stringency of the lockdown.                                       transmission of infection or ‘flatten the epidemic curve’
       Higher Initial Stringency was Effective in controlling actual        It aimed to buy the health care system some time to handle
         COVID-19 spread and deaths in States.                                  the surge in demand for its services and the development
       Uttar Pradesh, Gujarat, and Bihar have restricted the case              of effective treatment and a vaccine.
         spread the best;                                                 • The pandemic and associated lockdown measures engendered
       Kerala, Telangana, and Andhra Pradesh have saved the                the largest economic shock the world economy has witnessed
         most lives;                                                        in the last 150 years, thereby triggering a global recession
       Maharashtra has underperformed the most in restricting              this year.
         the spread of cases and in saving lives                             This recession was highly synchronized as the fraction
    • Relation of lockdown with Economic Recovery: Similarly, the               of economies experiencing an annual decline in national
      stringency index shows that V-shaped economic recovery                    per capita is highest since 1870. Thus it is aptly called as
      also strongly correlates with the stringency of the lockdown.             “Great Lockdown”
ECONOMIC SURVEY 2020-2021 - VOLUME 1 Summary by NEXT IAS
Economic Survey 2020-2021
Volume 1                                                                                                                                5
                                                                                                 Summary by NEXT IAS

• The COVID crisis presented a trade-off between lives and         India’s Humane Policy Response: Short-Term Pain,
  livelihoods as it required social distancing and limiting of     Longterm Gain:
  physical interactions thereby restricting economic activities.   • Timings of the intervention: Evidence from research and
• India’s policymaker's preference for the value placed              learnings from Spanish flu showed that timings of the
  on human lives versus the price of temporary economic              intervention were crucial as population density plays a major
  restrictions was evident from humane policy focus on saving        role in aggravating the speed of spread of the pandemic at
  lives even while paying the price of temporary GDP decline.        the onset.
  This got converted into a win-win in the medium to long term     • Stringent Lockdown: India imposed stringent national

                                                                                                   S
  that saves both lives and livelihoods.                             lockdown at an early stage and chose lives over livelihood
                                                                     as it had a clear objective of ‘Jaan Hai to Jahan hai’ and to
                                                                     ‘break the chain of spread’ before it reaches ‘community
                                                                     transmission’.

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                                                                   • 5 T Strategy: The ‘hotspots’ and ‘containment zones’ were

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                                                                     identified and the lockdown provided the necessary time
                                                                     to put in place the fundamentals of the '5 T' strategy - Test,
                                                                     Track, Trace, Treat, Technology.
                                                                   • Delayed Peak: It helped India to successfully delay the peak
                                                                     to September 2020 and flatten the pandemic curve thereby

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                                                                     saving millions of ‘lives’ and outperforming pessimistic
                                                                     expectations in terms of cases and deaths.
                      Flattening the Curve
                                                                   Efficacy of Initial Lockdown in Controlling the Pandemic:

               X
Efficacy of Lockdowns in A Pandemic: Learnings from                • Cross-country analysis using a Panel Regression Model: It has
Spanish Flu:                                                         been shown that India has 37.1 Lakhs fewer cases than what
• The pandemic curve needs to be flattened to spread the             was imagined and estimated by the model while actual cases
  pandemic over time and enable more people to receive               in the USA are more than the estimated cases of 62.5 lakhs.

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  proper health treatment, lowering the mortality rate.               It delayed its first peak till mid-September 2020 after
• Given the network effect, the transmission of pandemic                 which rising mobility has been accompanied by lower
  becomes faster in dense population regions.                            daily new cases.
                                                                      The institutional capacity (testing and health infrastructure)
• Data analysis of 1918 Spanish flu showed that intense

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                                                                         built during the initial period helped to cope with the peak
  Lockdowns Controlled Mortality due to the Flu but without
                                                                         caseload and sustain the controlled spread after the peak.
  reducing economic activity and contributing to faster growth
                                                                      It is the only country other than Argentina that has not
  in the medium term.
                                                                         experienced a second wave.
• Cities that intervened with lockdowns earlier and more              Most countries had to re-impose intermittent lockdowns
  aggressively experience stronger recovery in the economic              while India has been increasingly unlocking.
  front in the long run.                                              The model showed that Maharashtra has performed worst
• Thus, early lockdowns implemented during COVID 19 crisis               in the number of cases and deaths.
  and public health interventions emphasizing hand-washing,           With a recovery rate of almost 96 percent, it has among
  sanitization practices, and social/physical distancing were            the lowest fatality rates despite having the second-largest
  learnings from Spanish flu.                                            number of confirmed cases.
                                                                   • The lockdown, therefore, was a critical instrument in
Research Driven Policy Response Amid Unprecedented
                                                                     “flattening the curve” and saving lives.
Uncertatinity:
• Two fundamental strategies adopted to combat the pandemic:       V-Shaped Economic Recovery due to Timely Stringent
   Mitigation: Focuses on slowing the epidemic by reducing        Lockdown:
    the R0 (combining home isolation, social distancing, etc)      • Learning from Spanish flu, India implemented an early and
   Suppression: In the form of National lockdown carries            stringent lockdown from late March to May to curb the pace
    enormous social and economic costs have the potential            of the spread of COVID-19.
    to rapidly reduce or suppress the transmission below
                                                                   • This led to a 23.9% contraction in GDP as compared to the
    threshold R0=1 thereby reducing the case incidence.
                                                                     previous year's quarters.
ECONOMIC SURVEY 2020-2021 - VOLUME 1 Summary by NEXT IAS
Economic Survey 2020-2021                                                                                                  Volume 1
6
              Summary by NEXT IAS

    • The economy was gradually unlocked since June 2020 and          • During the Third Quarter
      has experienced a V-shaped recovery since then.                    With the easing of movement and health-related
                                                                           restrictions, the government transited in a calibrated
    Far-Sighted Policy Response for Economic Recovery:                     fashion to support investment and consumption demand
    • Need for social distancing and minimizing contact to tackle          through Atmanirbhar 2.0 and 3.0
      COVID 19 has meant that service sectors reliant on face-to-        It waited for the right time as it knew the expenditure push,
      face interactions—particularly wholesale and retail trade,           especially the capital expenditure would be most effective
      hospitality, and arts and entertainment— have seen larger            in stimulating ‘growth’ once there’s the reduction in health-
      contractions than manufacturing.                                     related curbs thereby boosting demand in the economy.

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    • The pandemic induced lockdowns led to local, regional,             The calibrated stance of the Government was corroborated
      and global supply disruptions hitting economic activity –            by increased savings in PMJDY accounts during April
      rendering a ‘first-order’ supply shock.                              June Quarter while as the economy revived the account
    • This, in turn, has led to a demand shock through both                balances have shown a decline towards increasing

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       Disruptions in the labor market affect household income.           expenditure.

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       Through the precautionary motive to save in the uncertainty
                                                                      Way Forward:
         amidst the health crisis.
                                                                      • V-shaped recovery: Despite the hard-hitting economic shock
    • Step by Step Approach: The fiscal policy response of the
                                                                          created by the global pandemic, India is witnessing a V-shaped
      Government of India to the pandemic was strategized with a
                                                                          recovery with a stable macroeconomic situation aided by a
      step-by-step approach.
                                                                          stable currency, comfortable current account, burgeoning forex

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    • During the first two-quarters of FY:2020-21,
                                                                          reserves, and encouraging signs in the manufacturing sector
       The Government ensured that funds for essential activities
                                                                          output.
         were available despite a sharp contraction in revenue
                                                                      • “Lockdown Dividend”: India is reaping the “lockdown dividend”
         receipts.

                   X
                                                                          from the brave, preventive measures adopted at the onset of the
       The initial approach was to provide a cushion for the
                                                                          pandemic, which was based on the humane principle advocated
         poor and section of society and to the business sector
                                                                          eloquently in the Mahabharata that “Saving a life that is in
         (especially the MSMEs) to tide over the distress caused
                                                                          jeopardy is the origin of dharma.”

                  E
         by disruption of economic activity.
                                                                      • Not waste a crisis: The policy maturity and the alacrity displayed
    • The Pradhan Mantri Garib Kalyan Yojana (PMGKY) was
                                                                          to not “waste a crisis” has helped the country to save both ‘lives’
      launched to ensuring
                                                                          and ‘livelihoods’ in its unique way.
       food security through the public distribution system,
                                                                      • Short term pain- Long term gain: It has shifted the focus away

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       direct benefit transfers to widows, pensioners, and women,
                                                                          from the short-term pain created by the crisis to the potential for
       additional funds for MGNREGS, and
                                                                          long-term gains engendered by the policy response.
       debt moratoria and liquidity support for businesses

                       MAJOR STRUCTURAL REFORMS UNDERTAKEN AS A PART OF ATMANIRBHAR BHARAT PACKAGE
           Sector                                                Structural Reform Undertaken
                                                Deregulation and Liberalization of Sectors
         Agriculture       • Farmers’ Produce Trade and Commerce (Promotion and Facilitation) Act, 2020
                           • Farmers (Empowerment and Protection) Agreement of Price Assurance and Farm Services Act, 2020
                           • Essential Commodities (Amendment) Act, 2020
           MSMEs           • New MSME definition covering almost 99 per cent of all firms enabling MSMEs to grow in size and create
                             jobs
                           • Removal of artificial separation between manufacturing and service MSMEs
           Labour          • Enactment of four labour codes namely, Wage Code, Industrial Relations Code, 2020, Code on
                             Occupational Safety, Health & Working Conditions Code, 2020 & Social Security Code, 2020
                           • 'One labour return, one licence and one registration'
       Business Process    • Simplification of the Other Service Provider (OSP) guidelines of the Department of Telecom. Several
      Outsourcing (BPO)      requirements, which prevented companies from adopting ‘Work from Home’ and ‘Work from Anywhere’
                             policies have been removed
ECONOMIC SURVEY 2020-2021 - VOLUME 1 Summary by NEXT IAS
Economic Survey 2020-2021
Volume 1                                                                                                                                7
                                                                                                    Summary by NEXT IAS

                    MAJOR STRUCTURAL REFORMS UNDERTAKEN AS A PART OF ATMANIRBHAR BHARAT PACKAGE
        Sector                                                    Structural Reform Undertaken
        Power            • Tariff Policy Reform: DISCOM inefficiencies not to burden consumers, Progressive reduction in cross
                           subsidies, Time bound grant of open access, etc.
                         • Privatization of Distribution in UTs
        PSUs             • PSUs in only strategic sectors
                         • Privatization of PSUs in non-strategic sectors

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   Mineral Sector        • Commercial Mining in Coal Sector
                         • Removal of distinction between captive and merchant mines
                         • Transparent auction of mining blocks

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                         • Amendment to Stamp Act, 1899 to bring uniformity in stamp duty across States
                         • Introduction of a seamless composite exploration-cum-mining-cum-production regime

                                                                       I
                                                   Strengthening Productive Capacity
       Industry          • Production Linked Incentive (PLI) Scheme for 10 identified sectors
                         • National GIS-enabled Land Bank system launched
        Space            • Level playing field provided to private companies in satellites, launches and space-based services

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                         • Liberal geo-spatial data policy for providing remote-sensing data to tech entrepreneurs
       Defence           • Corporatization of Ordnance Factory Board
                         • FDI limit in the Defence manufacturing under automatic route to be raised from 49 per cent to 74 per

                X
                           cent.
                         • Time-bound defence procurement process
                                                   Strengthening Productive Capacity

               E
      Education          • PM-eVidya to enable multi-mode and equitable access to education
                         • Manodarpan initiative for psychosocial support
 Social Infrastructure   • Scheme for Financial Support to Public Private Partnerships (PPPs) in Infrastructure Viability Gap Funding
                           (VGF) Scheme extended till 2024-25

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                                                         Ease of Doing Business
  Financial Markets      • Direct listing of securities by Indian public companies in permissible foreign jurisdictions
                         • Provisions to reduce time line for completion of rights issues by companies
                         • Private companies which list NCDs on stock exchanges not to be regarded as listed companies
     Corporates          • Including the provisions of Part IXA (Producer Companies) of Companies Act, 1956 in Companies Act,
                           2013
                         • Decriminalization of Companies Act defaults involving minor technical and procedural defaults
                         • Power to create additional/ specialized benches for NCLAT
                         • Lower penalties for all defaults for Small Companies, One-person Companies, Producer Companies &
                           Start Ups
                         • Simplified Proforma for Incorporating Company Electronically Plus (SPICe +) introduced
   Administration        • National platform for recruitment: National Recruitment Agency to conduct a Common Eligibility Test
                         • Revised guidelines on Compulsory retirement to remove ineffective or corrupt officials through
                           Fundamental Rule 56(j)/(l) and Rule 48 of CCS (Pension) Rule
                         • Faceless tax assessment and a 12-point taxpayers charter
                         • Fast track Investment Clearance through Empowered Group of Secretaries
ECONOMIC SURVEY 2020-2021 - VOLUME 1 Summary by NEXT IAS
Economic Survey 2020-2021                                                                                                Volume 1
8
              Summary by NEXT IAS

                                    DOES GROWTH LEAD TO DEBT
         02                   SUSTAINABILITY? YES, BUT NOT VICE-VERSA!
    CHAPTER
                           “The state collects tax for the greater welfare of its citizens in the same way as the sun evaporates
                              water, only to return it manifold in the form of rain” —Mahakavi Kalidasa’s Raghuvansham

    About:                                                              • In fact, simulations undertaken till 2030 highlight that given

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    • Need for fiscal spending amidst the COVID-19 crisis forces          India’s growth potential, debt sustainability is unlikely to be a
      us to ask the following questions                                   problem even in the worst scenarios.
       Does growth lead to debt sustainability?                        • This chapter thus demonstrates the desirability of using
        Or, does fiscal austerity foster growth?                         counter-cyclical fiscal policy to enable growth during economic

                                                                                                      A
    • This Chapter establishes clearly that growth leads to debt          downturns.

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      sustainability in the Indian context but not necessarily vice-    • It endeavours to
      versa.                                                               Break the intellectual anchoring that has created an
       This is because the interest rate on debt paid by the                 asymmetric bias against fiscal policy.
         Indian government has been less than India’s growth rate          Provide the intellectual anchor for the government to be
         by norm, not by exception.                                           more relaxed about debt and fiscal spending during a

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                                                                              growth slowdown or an economic crisis.
    • Debt sustainability depends on the “Interest Rate Growth Rate
      Differential” (IRGD), i.e., the difference between the interest   • The Survey’s call for more active, counter-cyclical fiscal
      rate and the growth rate in an economy.                             policy is not a call for fiscal irresponsibility.

                    X
       In advanced economies, the extremely low interest rates
          which led to negative IRGD and placed limitations on
          monetary policy have caused a rethink of the role of fiscal
          policy.

                   E
           This is because in already advanced economies,
            potential growth is lower.
        However, negative IRGD in India – not due to lower interest
         rates but much higher growth rates – must prompt a

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         debate on the saliency of fiscal policy, especially during
         growth slowdowns and economic crises.
                                                                                 Business cycle under various Fiscal Policy Stance
    • In the specific context of growth and debt sustainability, this
      chapter tries to clear confusion about causality – from growth    The Debate around Fiscal Expansion
      to debt sustainability or vice-versa?
                                                                        • Amidst the COVID-19 crisis, the debate around higher
       It studies the evidence across several countries to
                                                                          Government debt to support a fiscal expansion is
          show that growth causes debt to become sustainable in           accompanied by concerns about its implications for future
          countries with higher growth rates.                             growth, debt sustainability, sovereign ratings, and possible
        Such clarity about the causal direction is not witnessed in      vulnerabilities on the external sector.
         countries with lower growth rates.
                                                                        • While counter-cyclical fiscal policy is necessary to smooth out
    • As the COVID-19 pandemic has created a significant                  economic cycles, it becomes critical during an economic crisis.
      negative shock to demand, active fiscal policy can ensure that       This is because fiscal multipliers, are unequivocally
      the full benefit of seminal economic reforms is reaped by              greater during economic crises as compared to normal
      limiting potential damage to productive capacity.                      economic scenario
       Active policy here refers to one that recognises that fiscal       Fiscal Multipliers: They capture the aggregate return
          multipliers are disproportionately higher during economic          derived by the economy from an additional Rupee of
          crises than during economic booms                                  fiscal spending.
    • As the IRGD is expected to be negative in the foreseeable         • In a country like India, which has a large workforce employed
      future, a fiscal policy that provides an impetus to growth will     in the informal sector, counter-cyclical fiscal policy becomes
      lead to lower, not higher, debt-to-GDP ratios.                      even more paramount.
ECONOMIC SURVEY 2020-2021 - VOLUME 1 Summary by NEXT IAS
Economic Survey 2020-2021
Volume 1                                                                                                                                   9
                                                                                                   Summary by NEXT IAS

• Advanced Economies face crowding out: In advanced                     Conceptually, causality could flow in either direction.
  economies, where the public and private sector labour             • Higher debt leading to lower growth: The argument supporting
  markets are not too segmented, fiscal spending can increase         higher debt leading to lower growth is based on potential
  public sector employment, reduce the supply of labour in the        crowding out of private investment due to public expenditure
  private sector, bid up wages, and thereby crowd out private         which is discussed in the next section.
  sector employment.                                                • Higher growth leading to lower debt: Evidence over the last
   However, in a country like India, where the private and           two-and-a-half decades demonstrates clearly that in India,
      public sector labour markets are largely segmented, such        higher GDP growth causes the ratio of debt-to-GDP to decline

                                                                                                     S
      crowding out of private sector employment is minimal.           but not vice-versa.
• Thus, debt-financed public expenditure is more cost-effective     • The lagged relationship between real GDP growth rates
  to employ during recessions than during economic booms.             and change in general government debt-to-GDP levels was
                                                                      examined over the last 25 years

                                                                                                   A
                                                                       Over this period, real GDP growth rates and one-year-
                                                                         ahead change in general government debt-to-GDP levels

                                                                      I
                                                                         show a significant negative correlation.
                                                                       However, during the same time period, the correlation
                                                                         between change in general government debt-to-GDP
                                                                         levels and one-year-ahead growth rates turns out to be
                                                                         statistically indistinguishable from 0.

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                                                                       This implies that the direction of causality between the two
Interest Rate Growth Rate Differential (IRGD) and Debt                   variables is that higher growth leads to lower public debt in
                                                                         India, but not vice-versa.
Sustainability in India:

                X
• The ease with which a government can reduce its debt-             Direction of Causality in other Economies:
  to-GDP ratio depends primarily on the interest rate-growth
                                                                    • Unlike India, direction of causality between growth and debt
  differential (IRGD) i.e., the difference between the interest
                                                                      cannot be inferred for the advanced economies (as their
  rate and the growth rate in an economy.
                                                                      growth rate is low) when same data analysis was carried out.

               E
   More negative the IRGD, the easier (and quicker) it is for
                                                                    • Thus, this difference is extremely important to highlight because
      the Government to ensure debt sustainability.
                                                                      the implications for fiscal policy – especially during the current
       A negative IRGD thus creates an enabling environment
                                                                      crisis – are starkly different for India when compared to policies
          for debt sustainability.
                                                                      that mimic those followed by advanced economies.
   Conversely, if the IRGD is positive, the harder (and slower)

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      it is for the Government to ensure debt sustainability.       • However, when above data analysis was carried out during
                                                                      the period of high growth for advanced economies
• GDP Growth > Interest Rates: As a norm in India, over the last
                                                                       The result is identical to that obtained for India showing
  two and a half decades, GDP growth rates have been greater
                                                                         higher growth leads to lower debt-to-GDP but not vice
  than interest rates.
                                                                         versa.
   This inequality has thus led to a negative IRGD for most of
     the years during the last two and a half decades, which,       • Thus, even in the advanced economies where GDP growth
     in turn, has caused debt levels to decline.                      has been significantly lower than that in a high growth country
   However, trends in interest rate and growth rate in India         such as India, high growth phases lead to lowering of debt
     over this period highlights a perceptibly higher variability     but not vice versa.
     in the growth rates relative to interest rates.
                                                                    Crowding out due to Public Expenditure
   This implies that changes in IRGD are mostly attributable
     to changes in growth rates rather than the changes in          • The argument supporting higher debt leading to lower growth
     interest rates.                                                  is based on potential crowding out of private investment and
   Thus, it is a higher growth that provides the key to the          the Ricardian Equivalence Proposition (REP).
     sustainability of debt for India.                                 REP states that forward-looking consumers internalize
                                                                          the government’s fiscal choices when making their
In India, Growth Leads to Debt Sustainability, Not                        consumption decisions.
Vice-Versa:                                                            Thus, if there is increase in government spending (or
• How does the consistently negative IRGD affect the                      lowering of taxes) in the current period, forward looking
                                                                          consumers anticipate future tax increases and save in the
  relationship between debt and growth in India? Does higher
                                                                          current period to be able to pay for the future tax increases.
  growth lead to lower debt or lower debt cause higher growth?
ECONOMIC SURVEY 2020-2021 - VOLUME 1 Summary by NEXT IAS
Economic Survey 2020-2021                                                                                                Volume 1
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               Summary by NEXT IAS

            As a result, aggregate demand remains unchanged in          • India’s overall debt levels as a per cent of GDP are the lowest
             the current period.                                           amongst the group of G-20 OECD countries and also among
     • However, when REP doesn’t hold say due to proportional for          the group of BRICS nations.
       instance due to proportional taxes                                • Moreover, public debt and overall debt level for India has
        Higher public debt (i.e., lower public savings) may not           declined since 2003 and has been stable since 2011.
           be accompanied by increase in private savings and thus        • The Government’s debt portfolio is characterized by very low
           may also lead to lower total savings in the economy.            foreign exchange risk as the external debt is only 2.7 per cent
        This may put upward pressure on the interest rates,               of GDP (5.9 per cent of total Central Government liabilities)

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           resulting in crowding out of investment and thus negatively      Of the total public debt, 70 per cent is held by the Centre.
           impacting the growth rates.
                                                                         • The long maturity profile of India’s public debt (issuance of
        Also, higher levels of public debt are accompanied
                                                                           longer tenure bonds) along with a small share of floating rate
           by more taxes in the future to pay for the debt, thereby
                                                                           debt (floating rate debt of Central Government is less than

                                                                                                       A
           leading to lower lifetime wealth.
                                                                           5 per cent of public debt) tends to limit rollover risks, and
            This may decrease consumption and savings, eventually
                                                                           insulates the debt portfolio from interest rate volatility.

                                                                           I
              resulting in lower aggregate demand and growth rates.
                                                                         • Thus, considering the above factors and the fact that IRGD
     India Scenario:                                                       is expected to remain negative for India in the near future,
     • The phenomenon of crowding out of private investment is             simulations undertaken till 2030 highlight that given India’s
       based on the notion that supply of savings in the economy is        growth potential, debt sustainability is unlikely to be a

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       fixed.                                                              problem even in the worst scenarios.

     • However, for emerging economies such as India, an increase
                                                                         Policy Implications:
       in public expenditure in areas that boost private sector’s
                                                                         • The Covid-19 pandemic has created a significant negative
       propensities to save and invest, may enable private

                     X
                                                                           shock to demand.
       investment rather than crowding it out.
        This is because in an economy that has unemployed               • The Government has been extremely pro-active in launching
          resources, an increase in government spending increases          several seminal reforms to ensure high growth but their
                                                                           impact will manifest in the medium to long-term.

                    E
          the aggregate demand in the economy.
        This may induce the private sector to increase their            • Thus, only an active fiscal policy – one that recognises that the
          investment in new machinery to cater to the increased            risks from doing too little are much more than the risks from
          demand, and hence put the unused resources to                    doing too much – can ensure the economy remains in good
          productive uses.                                                 health to avail the full benefit of these significant reforms.

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     • Also, in rapidly growing economies the supply of savings is       • With the IRGD expected to be significantly negative for India in
       not fixed but expands with income growth.                           the foreseeable future, a well-designed expansionary fiscal
     • Also, for a country such as India with increased life               policy stance during economic crisis can contribute to better
       expectancy and favourable demographics – in the form                economic outcomes in two ways –
       of a large population of working age – savings would be              First, it can boost potential growth with multi-year public
       enhanced through meaningful jobs.                                      investment packages that raise productivity.
                                                                               At a time of excessive risk aversion in the private sector
     • Indian data analysis has found no evidences of crowding
                                                                                 during this crisis, it will crowd in private investment,
       out in over the last three decades post liberalization. It is
                                                                                 rather than crowd it out.
       indicated by
        No correlation was found between non-financial corporate           Second, it can prevent Indian economy from falling into a
          debt-to-GDP and bank credit change with changes in                  low wage-growth trap, as has happened in Japan during
          government debt-to-GDP during FY 2001 and FY 2019.                  the last two decades and thus could generate higher-
                                                                              paying jobs and boost productivity.
        No correlation found between public sector savings and
          private investments by the corporate sector or between         • With the National Infrastructure Pipeline (NIP) already laying
          public sector savings and private savings by the corporate       out the agenda for ambitious public spending, fiscal policy
          sector for the period FY1991 to FY2019.                          catering to funding NIP in the first few years can boost growth
                                                                           and thereby be self-financing.
     Structure of India’s Debt:                                          • Practical fiscal rules should be framed in Indian context that
     • India’s public debt-to- GDP has been significantly low              should for fiscal policy to be countercyclical to respond to
       compared to high global debt levels.                                slowdowns in the economy.
Economic Survey 2020-2021
Volume 1                                                                                                                                              11
                                                                                                   Summary by NEXT IAS

     03                        DOES INDIA’S SOVEREIGN CREDIT RATING
CHAPTER                          REFLECT ITS FUNDAMENTALS? NO!
                                     “Where the mind is without fear and the head is held high …
                        Into that heaven of freedom, my Father, let my country awake” —Rabindranath Thakur

About:

                                                                                                     S
• Despite being the fifth largest economy in the world, India
  has been rated as the lowest rung of the investment-grade

                                                                                                                                  Investment Grade
  (BBB-/Baa3) by sovereign rated agencies.

                                                                                                   A
      What is meant by Sovereign Credit Rating?

                                                                        I
 • A sovereign credit rating is an independent assessment of
   the creditworthiness of a country or sovereign entity.
 • It is done globally by a credit rating agency such as S&P
   and Moody’s.
 • It provides investors insights into the level of risk associated

                                                                      T
   with investing in the debt of a particular country.
 • These agencies evaluate the economic parameters and
   political environment of a country before providing a rating.

                X
 • Investment Grade Vs Speculative Grade: Bonds with a rating
   of BBB- (on the Standard & Poor's and Fitch scale) or
   Baa3 (on Moody's) or better are considered "investment-

                                                                                                                                  Speculative Grade
   grade."

               E
 • Bonds with lower ratings are considered "speculative" and
   often referred to as "high-yield" or "junk" bonds.

Bias towards Emerging Economies:

             N
• Emerging economies such as India and China has been                    Credit Rating Scale Comparison between some major CRAs
  constantly downgraded by credit rating agencies despite
  better performance in the vital economic parameter.                 Factors that determine Credit Rating in India
• Generally, the fifth-largest economy is rated with AAA rating       • Following are the factors which are taken into account while
  by agencies.                                                          determining the Sovereign Rating by credit rating agencies.

• But while rating China and India, these rating agencies             • Political Factors
  showed bias attitude.                                                  Political stability,
                                                                         Rule of law,
• China was rated A-/A2 in 2005 when it was the fifth-largest
                                                                         Control of Corruption,
  economy and now India has been rated BBB-/Baa3.
                                                                         Investor Protection,
India’s Credit Rating:                                                • Economic Factors
• Despite India’s growth rate of more than 8% during many                GDP growth rate,
                                                                         Inflation,
  years in the decade of 1990 and early 2000s, India’s credit
                                                                         General government debt (as a percent of GDP),
  rating was kept at “speculative grade”.
                                                                         Cyclically adjusted primary balance (as a percent of
• India’s credit rating was upgraded to investment grade by
                                                                           potential GDP),
  Moody’s in 2004, Fitch in 2006, and S&P in 2007.
                                                                         Current account balance (as a percent of GDP),
• During most of the decade of 1990 and early 2000s, India’s             Ease of doing business,
  high rate of economic growth co-existed with a sovereign               Short-term external debt (as a percent of reserves),
  credit rating of “speculative grade”.                               • Being a democratic country, India maintains most of the
                                                                        above political parameters.
Economic Survey 2020-2021                                                                                               Volume 1
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               Summary by NEXT IAS

     • Further, most of the economic factors have been fulfilled due    Limitations of the Sovereign Rating Downgrades on
       to the high growth rate in the last two decades.                 Indian Economy:
                                                                        • Foreign Direct Investment (FDI): International investors are
     India’s Economic Parameter: Truth Vs Rated:
                                                                          attracted towards an economy by observing its sovereign
     • India has consistently been rated below expectation as
                                                                          rating which reflects its economic and political stability.
       compared to its performance on various parameters which
                                                                        • A negative rating by an agency results in less investment in
       are taken by rating agencies during the period 2000-20.
                                                                          an economy resulting in a negative impact on its economic
     • Following are the parameters which show the biased attitude        development.

                                                                                                         S
       of rating agencies towards India.
                                                                        • Investor’s confidence: Better sovereign rating by credit rating
     Foreign Currency Debt VS FOREX Reserve:                              agency boosts investor’s confidence.

     • Although India bears a significant amount of debt in foreign     • It leads to long-term investment by them in the economy in
                                                                          form of FDI rather than FPI (Foreign Portfolio Investment).

                                                                                                       A
       currency denomination due to the comfortable size of its
       foreign exchange reserves it can pay the short-term debt         • Impact on Sovereign Bonds: Better sovereign rating by credit

                                                                          I
       of the private sector as well as the entire stock of India’s       rating agencies promote sovereign bonds in the international
       sovereign and non-sovereign external debt.                         market. Further, investments in sovereign bonds with
     • Government’s Debt: According to the Department of Economic         domestic currency denomination increases the value of the
       Affairs, India’s sovereign external debt as a percent of GDP       domestic currency.
       stood at a mere four percent as of September 2020.
                                                                        Way Forward:

                                                                        T
     • Further, 54 percent of India’s sovereign external foreign
                                                                        • India’s sovereign credit ratings do not reflect its fundamentals
       currency-denominated debt was owed to multilateral and IMF
                                                                          i.e. the growth of the emerging market has always been
       as of end-March 2020, which is not expected to impact credit
                                                                          negated by rating agencies.
       rating assessments.

                    X
                                                                        • It can be seen by examples of China and India when both
     • Non-Government Debt: Since India does not have full capital
       account convertibility, the private sector has to repay its        became the fifth-largest economy at one point in time.
       foreign currency-denominated debt by exchanging rupees           • Further, negative credit ratings impact the inflow of FDI and

                   E
       through the Forex reserves.                                        devaluate sovereign bonds in the international market.
     • India’s nongovernment short term-debt as a percent of            • Despite zero sovereign default history and good performance
       FOREX reserves stood at 19 percent as of September 2020            in other economic parameters, India has been downgraded
       which is also repayable.                                           by most of the credit rating agencies.

                 N
     • Total Debt Repayable: Hence, India’s FOREX reserves stood        • India must take up this issue international forums to make
       at US$ 584.24 as of January 15, 2021 (RBI), greater than           sovereign rating methodology more transparent.
       India’s total external debt (sovereign and non-sovereign) of
                                                                               Failure of Credit Rating Agencies to Predict
       US$ 556.2 bn as of September 2020.
                                                                                             Economic Crisis
     • Underrated: Despite better FOREX reserve and its ability
                                                                         Case I: East Asian Crisis (1997)
       to payback, India has consistently been rated much below
       expectation for its level of short-term external debt (percent    • Different economists have opined that Credit Rating
       of reserves) during the period 2000-20 as compared to other         Agencies (CRAs) aggravated the East Asian crisis by first
       countries with partial capital account convertibility.              failing to predict its emergence and thereafter becoming
                                                                           excessively conservative.
     Effect of India’s Sovereign Credit Rating Downgrades:               • CRAs downgraded East Asian crisis countries more
     • Short term impacts: Short term impacts of credit rating             than what would have been justified by these countries’
       downgrades can be seen in the swing in Sensex and                   worsening economic fundamentals.
       exchange rate.                                                    • This adversely affected the supply of international capital
     • Medium-term impact: There is a larger impact on Sensex over         to these countries and thus deepening the crisis in
       a month due to credit rating downgrades.                            affected economies.
     • Long-Term Effect: Long-term impacts of credit rating              Case II: Eurozone Crisis (2007)
       downgrades can be seen in the economy when Sensex                 • Credit rating agencies failed to estimate the European
       plunges for a longer time every year, constant devaluation          debt crisis which later turned out to be the Global Financial
       of Rupee against the dollar over the year, and decrease in          Crisis in 2008. If the European Debt Crisis would have
       Foreign portfolio Investment over the year.                         estimated, the latter could have been checked.
Economic Survey 2020-2021
Volume 1                                                                                                                                   13
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      04                                      INEQUALITY AND GROWTH:
CHAPTER                                      CONFLICT OR CONVERGENCE?
                                           Poverty is the parent of revolution and crime.              —Aristotle

About:                                                                         However, across the advanced economies, inequality

                                                                                                       S
• After the Global Financial Crisis (2008), it was concluded that               correlates negatively with the index of health and
  - ‘Inequality is an essential feature of capitalism.’                         social outcomes while income per capita correlates
   It can be assessed by the fact that there is direct correlation             positively.

                                                                                                     A
       between inequality and negative impact on various                • Drug Usage: Neither inequality nor income per capita among
       ‘Socio-Economic indicators’ such health, education, life           Indian states correlate strongly with drug usage.

                                                                          I
       expectancy, infant mortality, birth and death rates, fertility      However, inequality correlates strongly with drug usage in
       rates, crime, drug usage and mental health.                           the advanced economies.
• These impacts are similar to impact of poverty (low Per-capita        • Mental Health: On mental health, the effects of inequality and
  Income) on these ’Socio Economic Indicators’ but the impact             income per capita remain similar across the Indian states and
  is lesser than former.                                                  the advanced economies.

                                                                        T
• Conflict: This creates a state of conflict between economic           • Education: There is similar impact of inequality and income
  growth and inequality, thus leading of debate whether the               per capita in India on education.
  current model of economic growth is sustainable for socio-               However, in developed economies, income per-capita

                X
  economic growth as well or not.                                            does not impact education sector while inequality has
• Aim of the Chapter: In this chapter, the Survey answers the                adverse impact on education.
  question whether India should focus on removing inequality            • Life Expectancy: There is similar impact of inequality and
  or on economic growth?                                                  income per capita in India on life expectancy.

               E
                                                                           However, in developed economies, income per-capita
 • Note: Per-Capita income is globally considered as one of                   does not impact life expectancy while inequality has
   the measure of poverty.                                                    adverse impact on it.
 • The survey aims to compare impact of Per-Capita Income                  Mortality rate has similar trends in India and advanced

             N
   and widening inequality gap in India and advanced                          economies.
   economies around the world.                                          • Other indicators: Almost all other socio-economic indicators
 • Multidimensional Poverty also considers improvement in                 have similar trends in India and advanced economies.
   standard of living as direct consequence of rise in per                 These indicators include crime rate, death rate, birth rate
   capita income.                                                            and total fertility.
                                                                        • Asset and Consumption Pattern in India: There is clear co-
Impact of inequality and Per-Capita Income: India Vs                      relation between assets in possession and consumption
Advanced Economies:                                                       pattern.
• The Survey highlights that both economic growth and inequality           In India, the states which have greater consumption
  have similar relationships with socio-economic indicators.                  inequality also have greater asset inequality.

• In developed economies, inequality has more adverse impact            • Conclusion: Hence, it can be concluded that India has similar
  on socio–economic indicators than per-capita Income.                    impacts of inequality and poverty on its socio-economic
                                                                          indicators than advanced economies.
• But in India economic growth and inequality converge in
  terms of their effects on socio-economic indicators.
                                                                        Inequality and Poverty: Why do both need to be
Impact of different socio-economic indicators on                        distinguished?
poverty and inequality:                                                 • Inequality: It refers to the degree of dispersion in the
                                                                          distribution of assets, income or consumption while poverty
• Health: The index of health outcomes correlates positively
                                                                          refers to the assets, income or consumption of those at the
  with both inequality and income per capita across the Indian
                                                                          bottom of the distribution.
  states.
Economic Survey 2020-2021                                                                                              Volume 1
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               Summary by NEXT IAS

     • Poverty: When a person consumes goods and services below          • Different economists have opined that economic growth had
       a certain threshold then that person is termed as Poor.              a bigger impact on reducing poverty rather than inequality.
     • Relationship between Poverty and Inequality: When poverty is      • The findings reinforce previous studies on the empirical
       measured in relative term then it is termed as ‘inequality’.         relation between growth and poverty in India.
     • For Example: If Mohan and Ram earn Rs. 100 and Rs. 50 and         • Post-Liberalization growth: After analyzing six decades
       Rs. 20 is poverty line, then both are not poor.                      of data from 1957 to 2012 for India, it has been found that
        But, when their relative poverty is measured, Ram is               growth reduced poverty, and their association has acquired
          poorer than Mohan and this leads to inequality.                   more strength after the 1991 reforms.

                                                                                                          S
     Relative impact of economic growth and inequality                   • It has also been found that the pattern of growth has changed
     on poverty in India:                                                   significantly after 1991.

     • Estimation Methodology: Currently, Multi-dimensional Poverty      • Poverty is concentrating more and more in urban areas, as

                                                                                                        A
       Index (MPI) is best accepted method to gauge to measure              now one-in-three poor is living in urban areas, which was
       poverty.                                                             about one-in-eight in the early 1950s.

                                                                           I
     • It is based on three dimensions – education, health and           • In the post-liberalization period urban growth and non-
       standard of living which is estimated nu using ten indicators        agricultural growth has emerged as a major driver of national
       viz; education attainment, year of education; nutrition and          poverty reduction including rural poverty.
       mortality; and electricity, drinking water, sanitation, cooking
       gas, housing, and assets.                                         Conclusion:

                                                                         T
     • Headcount Ratio (HCR) counts persons as multi-dimensionally       • It has been established that relationship between Inequality
       poor if their composite score is more than 0.33.                    and socio-economic outcomes and economic growth and
        HCR of MPI is interpreted as proportion of population that        socio-economic outcomes is different in India from that

                     X
          is multi-dimensionally poor.                                     observed in advanced economies.

     • Estimated Outcomes: It has been estimated by the survey           • Thus, unlike in advanced economies, in India, economic
       that states that witnessed large reduction in poverty, using        growth and inequality converge in terms of their effects on
       the official estimates based on consumption, experience             socio-economic indicators.

                    E
       proportional reductions in multi-dimensional poverty as well.     • It has also been established that economic growth has a far
                                                                           greater impact on poverty alleviation than inequality.
     India’s growth trend in relation to poverty estimation:             • India’s current model of economic growth is more suitable for
     • Pre-Liberalization growth: World Bank in a report estimated         poverty alleviation than to fight inequality.

                  N
       that India could achieve sustained decline in poverty during      • Hence, India must focus on poverty alleviation rather
       1970s-1990s only when the GDP growth picked up from 3.5             decreasing inequality gap.
       per cent in the initial years.
                                                                         • After attaining a level of economic development, India would
     • Rise in the growth of mean consumption was responsible              be focusing on redistribution of resources (decreasing
       for approximately 87 per cent of the cumulative decline in          inequality).
       poverty, while redistribution contributed to only 13 per cent.

                              Correlation between poverty based on consumption and multi-dimensional poverty
Economic Survey 2020-2021
Volume 1                                                                                                                                    15
                                                                                                Summary by NEXT IAS

        05                                        HEALTHCARE TAKES
CHAPTER                                          CENTRE STAGE FINALLY!
                                      It is health that is real wealth and not pieces of gold and silver
                                                               —Mahatma K. Gandhi

About:

                                                                                                 S
                                                                   2.    Information Asymmetry-         Healthcare      systems
• A nation’s health depends upon citizen’s access to an                  Patients mostly remain         must be designed to
  equitable, affordable and accountable healthcare system                unaware of the quality of      preserve consumer faith,
  and the domestic economic growth is affected by healthy                healthcare they receive        investment and avoid

                                                                                               A
  labor productivity and burden of illnesses.                            and often rely on the          market failure.
• The ongoing pandemic has shown how a healthcare crisis                 reputation of the hospital

                                                                    I
  can get transformed into an economic and social crisis,                or health service provider.
  highlighting the interlinkage between healthcare and other             A conflict of interest may
  sectors of the economy.                                                arise between doctors and
• However, ‘saliency bias’ must be avoided wherein the policy            patients on account of pre-
  over-weights a recent phenomenon that may represent a six-             negotiated pricing and the

                                                                  T
  sigma event that may not repeat in the future in the same              type of procedures used.
  manner.                                                                E.g., C-sections fetch
                                                                         more monetary incentives
Key Highlights:

                X
                                                                         for doctors.
• Public Spending on healthcare: Prioritizing healthcare budget    3.    Hyperbolic Tendencies- Risky   Actively      shaping        and
  reflects the protection of the vulnerable to the financial             individual behavior such as    structuring         healthcare
  hardships on account of Out-of-Pocket Expenditure (OOPE).              not using masks, smoking       market     because          most

               E
   The Economic Survey 2021 highlights that a small                     etc.    create     negative    well-functioning           health
      increase in public expenditure on healthcare reduces               externalities for the entire   systems       are    structured
      OOPE drastically. Increasing the health spending from 1            healthcare system through      as oligopolies purchasing
      to 3% reduces OOPE from 60 to 30%.                                 higher costs and poorer        from oligopsony, instead

             N
   A similar trend was seen in China, the Philippines,                  outcomes, and individuals      of   individual     consumers
      Thailand, Indonesia, and Pakistan.                                 may not purchase health        purchasing          from      an
   Further, life expectancy in a country correlates positively          insurance.                     individual providers.
      with per-capita public health expenditure. Increasing
      life expectancy from 50 to 70 years could also raise the    • COVID-19 and India’s Healthcare Policy:
      economic growth rate by 1.4 % per year (WHO 2004).             “Saliency Bias”: The healthcare policy must decide
   Maternal Mortality correlates negatively with increased           upon the relative importance of communicable vs. non-
      public health expenditure.                                      communicable diseases because the present pandemic
                                                                      can make the healthcare policy a victim of Saliency Bias,
• Systematically designing Healthcare: The healthcare systems
                                                                      i.e., overweighing the recent phenomenon of a pandemic
  do not self-organize using the force of free-market because
                                                                      by focussing more on it.
  of the following aspects of the healthcare sector-
                                                                     However, the National Health Portal reported that between
 S.N.            Aspect               Required System Design          1990-2016, the share of Non-Communicable Diseases
        Uncertainty/Variability in                                    increased from 37% to 61% of all the deaths in India.
 1.                                  Health insurance can
        Demand- Inelastic demand     reduce macroeconomic
        (especially for emergency    level healthcare risk.
        care), and uncontrolled
        factors drive the demand
        for healthcare.
Economic Survey 2020-2021                                                                                             Volume 1
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               Summary by NEXT IAS

                                                                                                      S
                                                                         Comparison of Health Expenditure across different regions

                   Proportion of communicable and                         Reducing inequity: The distribution of the public subsidy
                  non-communicable diseases in India                       has improved in favor of the poor, especially in maternity

                                                                                                    A
                                                                           and child healthcare. Institutional deliveries have
         The Survey highlights that a better healthcare

                                                                        I
                                                                           increased and the percentage of the poorest utilizing
          infrastructure does not insure against communicable
                                                                           prenatal care through public facilities has increased from
          disease, as happened during the pandemic. As even
                                                                           19.9% to 24.7% from 2004 to 2018, with a similar trend for
          advanced economies could not deal effectively with the
                                                                           post-natal care.
          present pandemic. The focus must be on building the
                                                                          Low budget allocation: Health is a state subject and
          healthcare system generally rather than a specific focus

                                                                      T
                                                                           therefore state spending on health is important, which was
          on communicable diseases.
                                                                           66% in 2017 (National Health Accounts). However, India
                                                                           lags behind its peers. Further, the allocation varies as per
                                                                           state. While healthcare spending per capita increases with

                    X
                                                                           the GSDP per capita, healthcare spending as a percent
                                                                           of GSDP decreases with the GSDP per capita. Thus, the
                                                                           richer states spend a lower proportion of their GSDP on
                                                                           healthcare. A higher per capita spending reduces OOPE,

                   E
                                                                           in line with global findings.
                                                                          Low human resources for health: WHO has identified
                                                                           healthcare worker density as 44.5 per 10000 population
                                                                           to achieve SDGs by 2030 and India has nearly 23 as the

                 N
                                                                           density, with variability across states and an adverse mix
               NCD’s: one among top 10 reasons for deaths
                                                                           of healthcare professionals, doctors/nurse-midwives ratio.
     Present Healthcare Scenario:                                     • Unregulated private enterprises and market failures: Around
     • India under-performs as compared to the other Low and            74% of outpatient care and 65% of hospitalization care
       Lower Middle Income (LMIC) countries despite improvements        is provided through the private sector in urban India but
       in access and quality of healthcare provided. India ranks        unregulated private enterprises are a cause for concern due
       145th out of 180 countries in the Global Burden of Disease       to costlier unplanned re-admissions, higher costs of treatment
       Study of 2016.                                                   (inpatient and outpatient) compared to the public sector.
        Poor health outcomes: China, Bangladesh, Bhutan, etc.        • There is a low level of trust in the Indian healthcare sector.
          have improved better than India in MMR and IMR.               The problem of asymmetric information in healthcare is also
        Low access and utilization: At 3-4%, the hospitalization       reflected in the substantial variation in costs for treating the
          rates in India are among the lowest in the world. Despite     same disease between the public and private sector.
          an increasing burden of NCD, lower life expectancy,         • International Example: The healthcare policymakers should
          higher MMR, and IMR. This shows that there exist low          consider creating agencies to assess the quality of the
          healthcare access and utilization.                            healthcare providers – both doctors and hospitals. The
        High Out of Pocket Expenditure (OOPE): Out of Pocket           Quality and Outcomes Framework (QOF) introduced by the
          Expenditure in India is nearly 60%, one of the highest in     National Health Service (NHS) in the United Kingdom 2004
          the world according to the World Health Statistics 2020.      as well as other quality assessment practices introduced by
                                                                        NHS provide a good example.
Economic Survey 2020-2021
Volume 1                                                                                                                                  17
                                                                                                    Summary by NEXT IAS

    The NHS quality assessment practices included national         • Insurance penetration: Information asymmetry must also
     standards for the major chronic diseases, annual appraisal       be reduced to improve insurance penetration and quality
     of all doctors working in the NHS, and widespread use            of insurance products and reduce the burden of insurance
     of clinical audits to compare practices, sometimes with          premiums.
     the public release of data. These should be evaluated          • Regulation: A sectoral regulator to undertake regulation and
     carefully and considered for implementation.                     supervision must be considered because regulation is a key
• Telemedicine: The Survey mentions that the COVID-19                 lever for governments to affect the quantity, quality, safety,
  pandemic saw increased adoption of telemedicine, with               and distribution of services in health systems.

                                                                                                     S
  eSanjeevani OPD (a patient-to-doctor teleconsultation             • Telemedicine must be harnessed fully to improve healthcare
  system) recording almost a million consultations since April        access and this requires investment in internet connectivity
  2020.                                                               and infrastructure.
   It correlates positively with internet penetration in a state   • National Health Mission, which has mitigated inequity, must

                                                                                                   A
      and has a bearing on reducing geographic disparities in         continue in conjunction with Ayushman Bharat Scheme.
      healthcare access and utilization.
                                                                    • The National Health Policy 2017 envisages expansion of health

                                                                      I
                                                                      expenditures from 1% to 2.5-3 % of GDP to reduce Out of
Way Forward:
                                                                      Pocket Expenditure on healthcare to 30%.
• Ensuring quality: Healthcare policymakers should consider
                                                                    • The private healthcare sector provides the bulk of healthcare.
  creating agencies to assess the quality of the healthcare
                                                                      Relevant policies and regulations must curb information
  providers, similar to the Quality and Outcomes Framework

                                                                    T
                                                                      asymmetry and market failure. WHO highlights the same.
  (QOF) introduced by the National Health Service (NHS)
  in the UK. Quality assessment practices such as national          • Infrastructure: Develop agile infrastructure for health. Every
  standards for the major chronic diseases, annual appraisal          hospital may be equipped so that at least one ward in the
  of all doctors, clinical audits to compare practices, can be        hospital can be quickly modified to respond to a national

                X
  implemented.                                                        health emergency while caring for the normal diseases in
                                                                      usual times.
• Reducing information asymmetry: Data from National Digital
  Health Mission can be used along with artificial intelligence     • Leveraging technology: Technology-enabled platforms act as an

               E
                                                                       alternate distribution channel for remote delivery of healthcare
  to reduce the information asymmetry regarding patients.
                                                                       services, ensuring last-mile connectivity.

             N
              Share (per cent) of public sector in total healthcare, hospitalisation care and outpatient care
Economic Survey 2020-2021                                                                                                Volume 1
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               Summary by NEXT IAS

                                       PROCESS REFORMS: ENABLING
          06                       DECISION MAKING UNDER UNCERTAINTY
     CHAPTER                 International comparisons show that the problems of India’s administrative processes
                             occur less on account of lack of compliance to processes or regulatory standards, but
                                                         rather due to over-regulation.

     Regulatory effectiveness and its problems:                          • Opacity: Increasingly complex rules make it difficult for a third

                                                                                                         S
     • Effectiveness: The Economic Survey 2021 points out that             party to monitor how discretion is exercised.
       India performs better than its peers for having regulations       • Stringency: The Survey explains that more stringent
       in place and compliance to processes. But the regulatory            regulations may not necessarily reduce the room for discretion

                                                                                                       A
       effectiveness in reality suffers from undue delays, rent            for regulators. Eg. The Dodd-Frank Act of the USA enacted
       seeking, complex regulations and quality of regulation.             after the Global Financial Crisis of 2008 was 848 pages long

                                                                           I
        Banking on the ‘World Rule of Law Index’ 2020 published           and had 390 new Rules. This increased the ‘complexity risk’
           by World Justice Report which captures compliance to            of the Act as it made bank board’s responsible for 184 new
           due processes, effectiveness, timelines etc., the Survey        activities - an impossible task.
           highlights that India is relatively good at complying with    • Regulatory default: Regulation may be measured in terms of
           processes, but lags in regulatory effectiveness.                objective parameters whereas supervision may not be. Thus,

                                                                         T
        Compared to BRICS, India fares better (except South               regulators and decision-makers would prefer to substitute
           Africa) in terms of respecting due process but worse than       supervision with more and more regulations, irrespective of
           them in terms of effectiveness of those standards.              their effectiveness.
        Similarly, the World Bank’s Ease of Doing Business (EoDB)          Bureaucrats may even choose not to exercise discretion

                     X
           report (2020) shows that despite improving overall                 where it is available, substituting supervision with
           EoDB rank, India still lags behind in the sub-categories           mechanical regulations, such as in the case of tender
           ‘Starting a business’ and ‘Registering Property’ where the         bidding process, so as to avoid future questioning.

                    E
           its rank is 136 and 154 respectively, on account of large
           number of time-taking procedures to start and operate a
           company.
        Having regulations and enforcing process in one thing

                  N
           whereas effectiveness is another.
     • Incomplete regulations: Over-regulation results from not
       recognizing the inevitability of incomplete contracts and
       regulations in a world full of uncertainties. A contract can
       never fully capture all the future situations.
        The Survey highlights that incomplete regulations become
          inevitable when the reality of incomplete contracts is
          acknowledged.
                                                                                 Cross country comparison of Rule of Law indicator
        Regulators and policy-makers do not know the future for
          certain and therefore it is impossible to draft solution for   Overcoming Problems:
          every scenario, which may even be contrary to certain
                                                                         • Strengthen ex ante accountability: Governance in institutions
          assumptions held previously.
                                                                           can be strengthened by vesting more power in boards and
     • Discretion: Incomplete regulation makes a case for discretion       then holding them more accountable ex ante, instead of
       in decision-making. The problem cannot be overcome by               relying too much on ex-post audits.
       incorporating more detailed regulations either because
                                                                         • Bringing    transparency      in  decision-making      process:
       complex rules and regulations may cause them to be
                                                                           Transparency, apart from having intrinsic value, also promotes
       interpreted in multiple ways.
                                                                           trust in public institutions and makes market efficient. The
        The Survey points out that discretion and rules are not in a
                                                                           discretion needs to be balanced with the transparency in
           zero-sum relationship, such that the more rules there are
                                                                           decision making.
           the less the discretion there is and visa-versa.
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